The Sanctuary Model targets youth with emotional and behavior disorders, and with histories of maltreatment and/or exposure to family and community violence, who are placed in residential treatment. The Sanctuary Model (Bloom, 1997), developed by Sandra Bloom, M.D., for adults and adolescents in short-term, in-patient treatment, is being adapted for youth aged 12 to 20 years in residential treatment programs operated in Westchester County, New York by the Jewish Board of Family and Children's Services (JBFCS) -- one of the largest mental health and social services agencies in New York City. The Sanctuary Model is composed of two primary components: a) The active creation and maintenance of a non-violent, democratic, therapeutic community in which youth are empowered as key decision-makers to influence their own lives and their community; and b) psychoeducational modules designed to support cognitive re-structuring, communication skills, and pro-social behavior in order to assist youth in moving through four stages of recovery for victims of traumatic experiences. The specific aims of the proposed research are: 1) To examine the implementation of the Sanctuary Model by identifying proximal changes in the therapeutic environment of units participating in the Sanctuary Model, in comparison to standard residential practices; 2) To examine proximal effects of the Sanctuary Model on youth behaviors and skills within the program, in comparison to standard residential practices; 3) To examine generalization effects of the Sanctuary Model on youth behaviors and skills while on passes home and in the community, in comparison to standard residential practices. The aims will be achieved by using a 2 x 5 design (i.e., two service delivery conditions: Sanctuary Model vs. Standard Residential Services, by five data collection points at baseline, 3 months, 6 months, 9 months, and 12 months) with random assignment of 12 residential units to either the Sanctuary Model or Standard Residential Services. The twelve residential units (n=150 youth; n=96 staff) primarily serve youth, aged 12 - 20 years, with disruptive behavior disorders and attention deficit disorders. The Sanctuary Model condition will be implemented as an enhancement to Standard Residential Services; so, in effect, the research will examine differences in "Standard Residential Services with the Sanctuary Model enhancement" versus "Standard Residential Services without the enhancement." The proposed research will address a significant gap in the literature on interventions for high-risk youth by examining a targeted approach to interrupt the negative trajectory toward violence and poor mental health outcomes for youth with serious emotional disturbances.